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From Apnea to Zzzs: Caring for Kids' Sleep

Sleep is essential for all human beings; it has a key role in learning, memory, decision-making, emotional regulation, mental health, and healing. So when patients can’t sleep, is it bad sleep “hygiene” or something else, like a sleep disorder? In this post, we explore the ways good sleep habits help children of all ages grow up healthy and rested, and how parents and pediatricians can support good sleep – and identify when interventions are needed.

Good Sleep Grows from Good Habits

Chronic sleep deprivation has been linked to various health issues, including weakened immune systems, increased risk of obesity, and even mental health problems. On the other hand, prioritizing good sleep habits can have significant learning benefits for children. Studies have shown that adequate sleep enhances cognitive function, improves memory consolidation, and boosts attention span. Developing and maintaining good sleep habits is crucial for children to thrive physically, mentally, and academically.

Pediatricians practice many aspects of healthful sleep, such as safe sleep — why infants should be placed in a crib alone, without toys or coverings, on their backs — and the recommended sleep schedules for all ages. More challenging are the cases where parents ask “Why can’t my toddler sleep through the night without climbing into bed with us?” or “How can I keep my teen from scrolling social media late at night?” 

Behavioral sleep patterns can be changed, but Dr. Michael J. Strunc, MD says that it isn’t always easy. Dr. Strunc (he/him/his) is a pediatric neurologist with a sleep specialty, and discussed toddler sleep at length in his course on sleep during the 2023 American Academy of Pediatrics’ National Conference & Exhibition. 

While everyone requires a different amount of sleep to be healthy and feel rested, many children experience trouble sleeping, especially around adolescence. Issues can be identified at well visits with the BEARS mnemonic: bedtime issues, excessive daytime sleepiness, awakenings at night, regular duration, snoring. 

According to Dr. Strunc, “behavioral” insomnia is fairly common, and to remedy it, he recommends families take two weeks to reset their child’s sleep habits. This requires solid commitment from providers and parents! Dr. Strunc advises that families keep to a written bedtime plan that works for them, and it might look like this:

  • Dinner, then 30 minute bedtime routine
  • Bath
  • Stories
  • Cuddle
  • Bedtime, no “curtain calls”

Key points for a successful sleep habit include creating soothing sleep cues such as white noise or lights, and keeping electronics out of the bedroom. Also avoid excessive naps during the two week transition plan, which means that daycares and sitters must be aware of the plan, too.

Dr. Strunc also notes there are no FDA-approved medicines for children’s sleep. Melatonin is acceptable as a short term assist for sleep, and should be given consistently (same brand, same dosage).

Sleep and Comorbidities

Sleep and mental health are closely intertwined, particularly when it comes to conditions such as depression. Research has shown that there is an intersectional relationship between sleep disturbances and depressive symptoms in both children and adolescents. Lack of sleep or disrupted sleep patterns can contribute to the development or worsening of depressive symptoms, while experiencing depression can also lead to sleep problems such as insomnia or excessive sleepiness. 

Parents and healthcare teams must recognize this connection and address both sleep issues and mental health concerns in order to support the overall well-being of children and adolescents. Cognitive Behavioral Therapy (CBT) may be helpful for some patients, incorporating therapeutic ways to deal with stressors as well as practicing relaxation techniques.

One common sleep disorder is sleep apnea. Snoring is not typical in most children, and children with obesity, enlarged tonsils or adenoids, or with craniofacial anomalies may experience snoring as a symptom of sleep apnea. Due to crucial health effects, these patients require a sleep study for further evaluation and treatment. Parents should note too that children with obstructive sleep apnea may appear hyperactive, rather than sleepy.

Promoting good sleep habits in children is vital for their health and well-being. Adequate sleep not only supports physical growth but also plays a crucial role in cognitive function, memory consolidation, and attention span. On the other hand, poor sleep can have detrimental effects on children's immune systems, increase the risk of obesity, and contribute to mental health problems. Additionally, the relationship between sleep and mental health, such as depression, highlights the importance of addressing sleep issues along with mental health concerns. 

By recognizing the significance of sleep and implementing strategies to cultivate healthy sleep habits, parents and healthcare providers can help children thrive both physically and mentally. Good sleep truly serves as a foundation for children to reach their full potential.

Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.